Medicare Reimbursement for CPT 21408

This page covers a CPT procedure code (the specific descriptor is not shown because CPT text is licensed by the AMA). It shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted by locality, and compares the non-facility (office) and facility (hospital/ASC) payment settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$814.31	$814.31
ALASKA* (AK)	$1008.45	$1008.45
ALABAMA (AL)	$740.60	$740.60
ARKANSAS (AR)	$731.52	$731.52
ARIZONA (AZ)	$793.22	$793.22
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$940.76	$940.76
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$955.09	$955.09
OXNARD-THOUSAND OAKS-VENTURA (CA)	$855.11	$855.11
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$864.02	$864.02
NAPA (CA)	$904.37	$904.37
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$943.39	$943.39
VALLEJO (CA)	$900.58	$900.58
BAKERSFIELD (CA)	$822.70	$822.70
CHICO (CA)	$816.22	$816.22
FRESNO (CA)	$816.22	$816.22
HANFORD-CORCORAN (CA)	$816.22	$816.22
MADERA (CA)	$816.22	$816.22
MERCED (CA)	$816.22	$816.22
MODESTO (CA)	$816.22	$816.22
REDDING (CA)	$816.22	$816.22
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$841.20	$841.20
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$845.61	$845.61
SALINAS (CA)	$842.24	$842.24
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$965.86	$965.86
SANTA CRUZ-WATSONVILLE (CA)	$856.04	$856.04
SANTA ROSA-PETALUMA (CA)	$863.95	$863.95
STOCKTON (CA)	$816.22	$816.22
VISALIA (CA)	$816.22	$816.22
YUBA CITY (CA)	$816.22	$816.22
EL CENTRO (CA)	$816.60	$816.60
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$854.16	$854.16
SAN LUIS OBISPO-PASO ROBLES (CA)	$830.00	$830.00
SANTA MARIA-SANTA BARBARA (CA)	$843.24	$843.24
REST OF CALIFORNIA (CA)	$816.22	$816.22
COLORADO (CO)	$822.86	$822.86
CONNECTICUT (CT)	$863.60	$863.60
DC + MD/VA SUBURBS (DC)	$902.62	$902.62
DELAWARE (DE)	$804.72	$804.72
FORT LAUDERDALE (FL)	$881.09	$881.09
MIAMI (FL)	$945.94	$945.94
REST OF FLORIDA (FL)	$839.18	$839.18
ATLANTA (GA)	$836.27	$836.27
REST OF GEORGIA (GA)	$794.56	$794.56
HAWAII, GUAM (HI)	$825.62	$825.62
IOWA (IA)	$740.33	$740.33
IDAHO (ID)	$747.82	$747.82
EAST ST. LOUIS (IL)	$867.24	$867.24
SUBURBAN CHICAGO (IL)	$885.71	$885.71
CHICAGO (IL)	$919.18	$919.18
REST OF ILLINOIS (IL)	$830.04	$830.04
INDIANA (IN)	$751.08	$751.08
KANSAS (KS)	$745.10	$745.10
KENTUCKY (KY)	$772.14	$772.14
NEW ORLEANS (LA)	$805.93	$805.93
REST OF LOUISIANA (LA)	$774.18	$774.18
METROPOLITAN BOSTON (MA)	$885.06	$885.06
REST OF MASSACHUSETTS (MA)	$822.24	$822.24
BALTIMORE/SURR. CNTYS (MD)	$862.75	$862.75
REST OF MARYLAND (MD)	$815.97	$815.97
SOUTHERN MAINE (ME)	$782.83	$782.83
REST OF MAINE (ME)	$759.37	$759.37
DETROIT (MI)	$856.25	$856.25
REST OF MICHIGAN (MI)	$796.41	$796.41
MINNESOTA (MN)	$769.06	$769.06
METROPOLITAN ST. LOUIS (MO)	$799.08	$799.08
METROPOLITAN KANSAS CITY (MO)	$792.97	$792.97
REST OF MISSOURI (MO)	$768.05	$768.05
MISSISSIPPI (MS)	$749.52	$749.52
MONTANA** (MT)	$814.16	$814.16
NORTH CAROLINA (NC)	$764.86	$764.86
NORTH DAKOTA** (ND)	$768.28	$768.28
NEBRASKA (NE)	$741.43	$741.43
NEW HAMPSHIRE (NH)	$817.77	$817.77
NORTHERN NJ (NJ)	$897.11	$897.11
REST OF NEW JERSEY (NJ)	$867.98	$867.98
NEW MEXICO (NM)	$803.28	$803.28
NEVADA** (NV)	$801.69	$801.69
MANHATTAN (NY)	$938.30	$938.30
NYC SUBURBS/LONG ISLAND (NY)	$967.96	$967.96
POUGHKPSIE/N NYC SUBURBS (NY)	$879.78	$879.78
QUEENS (NY)	$933.56	$933.56
REST OF NEW YORK (NY)	$775.27	$775.27
OHIO (OH)	$787.04	$787.04
OKLAHOMA (OK)	$762.72	$762.72
PORTLAND (OR)	$836.73	$836.73
REST OF OREGON (OR)	$790.02	$790.02
METROPOLITAN PHILADELPHIA (PA)	$849.91	$849.91
REST OF PENNSYLVANIA (PA)	$783.76	$783.76
PUERTO RICO (PR)	$816.68	$816.68
RHODE ISLAND (RI)	$824.43	$824.43
SOUTH CAROLINA (SC)	$778.32	$778.32
SOUTH DAKOTA** (SD)	$762.86	$762.86
TENNESSEE (TN)	$749.26	$749.26
BRAZORIA (TX)	$797.71	$797.71
DALLAS (TX)	$805.77	$805.77
GALVESTON (TX)	$802.07	$802.07
HOUSTON (TX)	$844.54	$844.54
BEAUMONT (TX)	$779.95	$779.95
FORT WORTH (TX)	$803.57	$803.57
AUSTIN (TX)	$824.91	$824.91
REST OF TEXAS (TX)	$790.44	$790.44
UTAH (UT)	$787.17	$787.17
VIRGINIA (VA)	$786.08	$786.08
VIRGIN ISLANDS (VI)	$816.68	$816.68
VERMONT (VT)	$772.83	$772.83
SEATTLE (KING CNTY) (WA)	$893.73	$893.73
REST OF WASHINGTON (WA)	$818.20	$818.20
WISCONSIN (WI)	$747.22	$747.22
WEST VIRGINIA (WV)	$805.71	$805.71
WYOMING** (WY)	$794.17	$794.17

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare's PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — that reflect the relative resources needed to furnish the service. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the provider's locality to account for regional cost differences, then the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility and facility rates differ mainly because the practice-expense RVU is higher in non-facility (office) settings, where the practice bears more overhead, and lower in facility settings where the facility itself is paid separately. The resulting allowed amount is what Medicare recognizes as payment in full before cost-sharing is applied.

RVUs — work 12.46, practice expense 9.6 (non-facility) / 9.6 (facility), malpractice 2.32 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on national/locality inputs; actual payment can differ.
Medicare typically pays 80% of the allowed amount after the patient meets the Part B deductible; the patient or secondary payer is generally responsible for the remainder.
Modifiers (e.g., bilateral, multiple procedure, assistant-at-surgery) can increase or reduce the final paid amount.
Sequestration and other federal payment adjustments may reduce the actual disbursed amount.
Annual budget-neutrality adjustments and conversion factor updates change these figures each calendar year.
Always confirm the exact allowed amount and any applicable adjustments with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does the amount differ between non-facility and facility settings?

The practice-expense RVU component is different for each setting because overhead costs (staff, supplies, equipment) are borne differently depending on whether the service is performed in an office versus a hospital or ASC.

Does this amount apply in every state or region?

No. The national figure is a baseline; the actual Medicare payment is adjusted by locality-specific GPICs, so the amount can be higher or lower depending on where the service is billed.

Will the patient pay 20% of this exact figure?

Generally yes, after the deductible is met, but the 20% coinsurance is based on the actual locality-adjusted allowed amount, not necessarily the national figure shown here.

Why might my MAC's payment differ from this estimate?

Differences can arise from locality adjustments, applied modifiers, claims-specific edits, sequestration, or mid-year/annual updates to RVUs and the conversion factor.

More free billing tools: all Medicare fees · fee calculator · denial code decoder

Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.